This project explores the process of communication between children, parents and family physicians in routine pediatric visits in a family practice center. The long-term objectives are to specify age-appropriate models for active involvement of children in primary care encounters, test these models and articulate curricular for teaching primary care physicians how to promote direct child involvement in the diagnostic and treatment process. This project focuses specifically upon the most basic stage: that of analyzing and describing the flow of communication in such a three-party encounter and identifying variables which influence the transactions. The data are derived from 110 videotaped encounters including a child (identified as patient), one parent or guardian and a family physician. The analytic scheme includes a quantitative analysis of the communication using a modification of Bales Interaction Process Analysis with multiple regression and a qualitative conversation analysis to identify general patterns (eg. adults to child, physicians to patient, etc.). Applications of the findings will relate to an improved understanding of physicians' impact on children's health and illness behavior and to the training of primary care practitioners in pediatric encounters.